Title:Correlation of Waist to Calf Circumference Ratio and Carotid Intima-Media Thickness in Diabetes Mellitus
Volume: 17
Issue: 3
Author(s): Harish A. Rao, Prakash Harischandra*Srikanth Yadav
Affiliation:
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore,India
Keywords:
Waist circumference, calf circumference, waist calf ratio, carotid intima-media thickness, diabetes mellitus, carotid
atherosclerosis.
Abstract: Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease because
of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained
immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet
the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral
subcutaneous fat and is inversely associated with the occurrence of carotid plaques (CP). Multiplicative
and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in the
event of CP suggest that the two measures should be taken into account commonly while assessing vascular
risk profile.
Aims & Objectives: To ascertain if waist to calf circumference ratio (WCR) is a marker of carotid atherosclerosis
in patients with type 2 diabetes mellitus, and the correlation between waist to calf circumference
ratio and carotid intima-media thickness (CIMT ) in patients with Type 2 diabetes.
Materials and Methods: A cross-sectional study at Hospital affiliated to Kasturba Medical college
Mangalore from Sept 2016 to Sept 2018.
Patients with type 2 DM as per ADA criteria, age >18years, are recruited for the study.
Results and Discussion: In our study, with 150 population, 25 patients had carotid atherosclerosis and 20
patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07, and 99.85 &
the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the
range of 3.12 to 3.26. The difference was statistically significant with a p-value of <0.05. In our study,
it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly, calf
circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR.
Conclusion: To conclude, in our population-based study of 150 subjects, we found that carotid atherosclerosis
is significantly more in people with increased waist calf circumference ratio. WCR may be a
new, useful, and practical anthropometric index that facilitates the early identification of diabetic subjects
with high risk for cardiovascular disease. Validation of this finding in individual populations is required.
Future studies should test the association of calf circumference with carotid intima-media thickness
and carotid plaques using better measures than ultrasound, such as magnetic resonance imaging.
Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is
required.
